Red flags to suspect inborn errors of immunity in patients with autoimmune diseases; [Señales de alerta para sospechar de errores innatos de la inmunidad en pacientes con enfermedades autoimmunitarias]

Autores organización

• 

  Juliette De Avila Quiroga

  Autor

• Maria Consuelo Romero Sanchez

  Autor

Autores

• Vélez N.
• Cortés J.
• Barrero N.
• Rojas L.
• Bello J.M.

Unidades de investigación

• Grupo de Inmunología celular y molecular Universidad El Bosque (InmuBo)

  Investigador

  Maria Consuelo Romero Sanchez

Resumen

Inborn errors of immunity are monogenic disorders that predispose patients to immune dysregulation, autoimmunity, and infection. Some autoimmune diseases, such as autoimmune cytopenias, systemic lupus erythematosus, and inflammatory bowel diseases, are increasingly recognized as phenotypes of inborn errors of immunity. The objective of this article was to identify red flags or clinical/laboratory markers to suspect inborn errors of immunity in patients with autoimmune cytopenias, systemic lupus erythematosus, and inflammatory bowel diseases through a systematic literature review. The study followed the systematic reviews and meta-analysis guidelines (PRISMA). After selection, we included 36 articles, and their methodological quality was verified using the Joanna Briggs Institute tools for individual risk of bias analysis. The principal red flags in autoimmune cytopenias are chronic, recurrent, and refractory cytopenias, recurrent infection, severe infectious complications associated with immunosuppressive treatment, and chronic lymphoproliferation. In systemic lupus erythematosus, red flags include age of onset before five years, severe organ involvement, chilblain lesions, and chronic lymphoproliferation. For inflammatory bowel diseases, red flags are an age of onset before two years, resistance to conventional therapies, atypical endoscopic or histologic findings, and consanguineous parents. Autoimmune diseases may be the primary manifestation of inborn errors of immunity in pediatric and adult patients. An early diagnosis of a monogenic disorder allows for the tailoring of effective treatment plans, providing prognostic information to families, and offering genetic counseling. © (2024), (Instituto Nacional de Salud). All rights reserved.

Keywords

• anemia hemolítica autoinmunitaria; anemia, hemolytic, autoimmune; autoimmune diseases; Autoimmunity; autoinmunidad; citopenia; cytopenia; early-onset immune dysregulation; enfermedades autoinmunitarias; enfermedades inflamatorias intestinales; inflammatory bowel disease; lupus eritematoso sistémico; lupus erythematosus, systemic; thrombocytopenia; trombocitopenia;Autoimmune Diseases; Humans; Inflammatory Bowel Diseases; Lupus Erythematosus, Systemic; autoimmune disease; diagnosis; human; immunology; inflammatory bowel disease; systemic lupus erythematosus